Provider Demographics
NPI:1093425779
Name:EGBE, ARA DORCAS JANET
Entity Type:Individual
Prefix:
First Name:ARA DORCAS
Middle Name:JANET
Last Name:EGBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13235 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4739
Mailing Address - Country:US
Mailing Address - Phone:571-351-7788
Mailing Address - Fax:
Practice Address - Street 1:13235 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4739
Practice Address - Country:US
Practice Address - Phone:571-351-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00201238374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide